[Treatment of talar chondral lesions by solid chondral graft -- first experience]

The aim of this report is to draw attention to new possibilities of treating chondral lesions of the talus, using a solid chondral graft consisting of autologous chondrocytes grown on a three-dimensional matrix of the tissue glue Tissucol. This method is used in grade II to grade IV chronic lesions and grade IV acute lesions, as classified according to the Berndt and Harty system. Patients' age at implantation should not exceed 40 years. When a lesion is found by arthroscopy on the talar dome, a part of cartilage from a non-weight-bearing surface, most frequently the neck of the talus or the anterior edge of the tibia, is collected. The cartilage is sent to the tissue bank. The preparation of a chondral graft (fragmentation, isolation and cultivation of chondrocytes) takes from 15 to 35 days. After shaping the graft from chondrocytes and Tissucol tissue glue in a special mould, transplantation is carried out. In 2003 we used this method in two patients. They both were male sportsmen, football players, aged 35 and 30 years, respectively. At the time of this report, the former patient was 8 months and the latter 3 months after implantation. The first patient, aged 35, was without complaints at 8 months after implantation. The other patient, a 30-year-old football player, who was still followed up, was without complaints and continued with rehabilitation and full weight-bearing of the extremity. Magnetic resonance imaging performed 3 months post-operatively showed good incorporation of the chondral graft in both patients.